Healthcare Provider Details

I. General information

NPI: 1457816084
Provider Name (Legal Business Name): AILEEN M ARGUETA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 L ST
BAKERSFIELD CA
93301-4522
US

IV. Provider business mailing address

1001 TOWER WAY STE 150A
BAKERSFIELD CA
93309-1597
US

V. Phone/Fax

Practice location:
  • Phone: 866-266-4898
  • Fax:
Mailing address:
  • Phone: 661-634-9877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number9582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: